Objective:To evaluate the anti-reflux effect of digestive tract reconstruction using esophageal-tubular gastric asymmetric anastomosis after radical resection of esophageal and esophagogastric junction cancer.Methods:The main steps were as follows:(1)oblique incision of the lower esophagus;(2)curved incision of the tubular anterior gastric wall;(3)the lower end of the esophagus was anastomosed to the tubular gastric incision with a 90-degree torsion; (4)The anterior wall of the anastomosis was reinforced with a transverse-inverted suture,the posterior wall with a folded suture,and the corners of the gastric stump were buried with sutures.The anastomosis operation time,postoperative complications and postoperative hospital stay were recorded;the reconstructed structure and anti-reflux effect of the anastomosis were observed by digestive tract radiography,gastroscopy and follow-up investigation.Results:The Department of Gastrointestinal and Thoracic Surgery of Huaian First People's Hospital, affiliated to Nanjing Medical University, treated 5 patients of esophagogastric junction cancer and 20 esophageal cancer cases between August 2022 and November 2024, including 19 men and 6 women, with a mean age of (66.7±7.4) years. The mean anastomosis time was (35.4±5.9) minutes, the intraoperative blood loss was (117.6±33.4) ml and the mean postoperative hospital stay was(16.6±5.2) days, with no complications such as anastomotic leakage and bleeding. Postoperative digestive tract radiography (Trendelenburg position)showed that all the patients had no contrast reflux,gastroscopy showed no signs of reflux esophagitis and bile reflux gastritis, the anastomosis showed an inverted whiskers valve-like structure. The median follow-up time was (16.8±6.3) months, and all patients had no reflux symptoms such as acid reflux and belching,and no acid suppressive medication was needed.Conclusion:The esophageal-tubular gastric asymmetric anastomosis is a safe and effective antireflux reconstruction technique.

BACKGROUND:Basketball shoes are one of the most important pieces of athletic equipment in basketball,helping to improve players'performance and reduce the risk of injury.With the development of basketball,the demand for basketball shoe performance is getting higher and higher.OBJECTIVE:To systematically review and summarize the effects of different functional parameters of basketball shoes on the wearer's biomechanical performance,and to investigate the effects of each functional parameter of basketball shoes on athletic performance and injury risk.METHODS:Relevant literature addressing the effect of basketball shoes'functional parameters on human biomechanics from CNKI,WanFang,Web of Science,ScienceDirect and other databases was searched by computer,with the search terms of"basketball,basketball shoe,shoes,footwear,sports biomechanics,kinematics,kinetics"in Chinese and English.All the retrieved literature was evaluated and screened,and finally 61 articles were included for literature review.RESULTS AND CONCLUSION:Existing studies on functional parameters of basketball shoes include shoe collar height and heel counter-stiffness,midsole hardness,midsole cushioning,midsole thickness,forefoot flexural stiffness,whole shoe mass,and outsole traction.The functional parameters of basketball shoes play a role in improving sports performance and reducing the risk of sports injuries:(1)Compared with low-top shoes,high shoe collars can reduce the risk of ankle sprains,but may affect sports performance,ankle proprioception,and increase the load on the knee.(2)Better midsole cushioning or softer midsoles can effectively reduce vertical impact,and the forefoot cushioning structure can effectively improve the athletic performance of lateral movement.(3)The midsole thickness of 11 mm in the forefoot and 20 mm in the rearfoot can obtain the best ankle stability and sprinting performance.(4)Improving the outsole traction and forefoot bending stiffness can significantly improve the performance of jumping,sprinting,and side-cutting.There are diminishing returns to the improvement of athletic performance by improving outsole traction.(5)Lighter basketball shoes can improve athletic performance,but this effect only occurs when the wearer is aware of the shoes'weight.

Objective:To evaluate the anti-reflux effect of digestive tract reconstruction using esophageal-tubular gastric asymmetric anastomosis after radical resection of esophageal and esophagogastric junction cancer.Methods:The main steps were as follows:(1)oblique incision of the lower esophagus;(2)curved incision of the tubular anterior gastric wall;(3)the lower end of the esophagus was anastomosed to the tubular gastric incision with a 90-degree torsion; (4)The anterior wall of the anastomosis was reinforced with a transverse-inverted suture,the posterior wall with a folded suture,and the corners of the gastric stump were buried with sutures.The anastomosis operation time,postoperative complications and postoperative hospital stay were recorded;the reconstructed structure and anti-reflux effect of the anastomosis were observed by digestive tract radiography,gastroscopy and follow-up investigation.Results:The Department of Gastrointestinal and Thoracic Surgery of Huaian First People's Hospital, affiliated to Nanjing Medical University, treated 5 patients of esophagogastric junction cancer and 20 esophageal cancer cases between August 2022 and November 2024, including 19 men and 6 women, with a mean age of (66.7±7.4) years. The mean anastomosis time was (35.4±5.9) minutes, the intraoperative blood loss was (117.6±33.4) ml and the mean postoperative hospital stay was(16.6±5.2) days, with no complications such as anastomotic leakage and bleeding. Postoperative digestive tract radiography (Trendelenburg position)showed that all the patients had no contrast reflux,gastroscopy showed no signs of reflux esophagitis and bile reflux gastritis, the anastomosis showed an inverted whiskers valve-like structure. The median follow-up time was (16.8±6.3) months, and all patients had no reflux symptoms such as acid reflux and belching,and no acid suppressive medication was needed.Conclusion:The esophageal-tubular gastric asymmetric anastomosis is a safe and effective antireflux reconstruction technique.

Objective To explore current status of alexithymia in middle-aged and young patients with stroke,and to analyse the influencing factors and summarise the nursing strategies therefore to provide references for nursing interventions.Methods A convenience sampling method was used to select 220 patients who had stroke and admitted to the wards of Neurology and Neurosurgery in our hospital between February and April 2024.The patients were surveyed using a general information questionnaire,the stroke symptom experience scale,the stroke-specific quality of life scale(SSQOL),and the Toronto alexithymia scale-20(TAS-20).Pearson correlation analysis was used to evaluate the relationship between alexithymia,stroke symptom experience and quality of life in middle-aged and young patients with stroke.Multiple linear regression analysis was used to identify the influencing factors of alexithymia.Results A total of 205 middle-aged and young patients with stroke completed the study.The mean score of the TAS-20 was 74.67±19.68,with average subscale scores for difficulty in identifying feelings of 3.45±0.73,difficulty in describing feelings of 3.49±0.74 and externally-oriented thinking of 3.22±0.69.The prevalence of alexithymia was 74.63%.Alexithymia was found positively correlated with stroke symptom experience and negatively correlated with quality of life(all P<0.05).The education,family income and stroke symptom experience were the protective factors for alexithymia,while quality of life was a risk factor(all P<0.05).These factors collectively explained 61.50%of the variance in alexithymia.Conclusion Middle-aged and young patients with stroke have a high level of alexithymia.Patients with higher education,family monthly income≥2,000 yuan,lower quality of life and higher symptom burden are more likely to develop an alexithymia.Nursing staff should seek appropriate methods to guide patients in expressing their emotions in order to prevent the alexithymia.

Central venous access device-related thrombosis (CRT) refers to the obstructive or non-obstructive clots formed around the central venous access device (CVAD).It may lead to risks such as loss of vascular access, pulmonary embolism, post-thrombotic syndrome.Due to the heterogeneity of underlying diseases and the specific characteristics of CVAD placement in children, there is insufficient evidence for the diagnosis and treatment of CRT in children.This article reviews the diagnosis, treatment and prevention of CRT in children to provide reference for clinical management.

Objective To explore current status of alexithymia in middle-aged and young patients with stroke,and to analyse the influencing factors and summarise the nursing strategies therefore to provide references for nursing interventions.Methods A convenience sampling method was used to select 220 patients who had stroke and admitted to the wards of Neurology and Neurosurgery in our hospital between February and April 2024.The patients were surveyed using a general information questionnaire,the stroke symptom experience scale,the stroke-specific quality of life scale(SSQOL),and the Toronto alexithymia scale-20(TAS-20).Pearson correlation analysis was used to evaluate the relationship between alexithymia,stroke symptom experience and quality of life in middle-aged and young patients with stroke.Multiple linear regression analysis was used to identify the influencing factors of alexithymia.Results A total of 205 middle-aged and young patients with stroke completed the study.The mean score of the TAS-20 was 74.67±19.68,with average subscale scores for difficulty in identifying feelings of 3.45±0.73,difficulty in describing feelings of 3.49±0.74 and externally-oriented thinking of 3.22±0.69.The prevalence of alexithymia was 74.63%.Alexithymia was found positively correlated with stroke symptom experience and negatively correlated with quality of life(all P<0.05).The education,family income and stroke symptom experience were the protective factors for alexithymia,while quality of life was a risk factor(all P<0.05).These factors collectively explained 61.50%of the variance in alexithymia.Conclusion Middle-aged and young patients with stroke have a high level of alexithymia.Patients with higher education,family monthly income≥2,000 yuan,lower quality of life and higher symptom burden are more likely to develop an alexithymia.Nursing staff should seek appropriate methods to guide patients in expressing their emotions in order to prevent the alexithymia.

Objective To study the role and influence of basic Alkaline ceramidase 1 on mucosal barrier and immune regulation in ulcerative colitis(UC).Methods Acer1 knockout mice(Acer1 KO)were constructed,and the UC model was induced by continuous drinking water of sodium dextran sulfate(DSS)for 7 days,and the severity of symptoms of UC disease in C57 and Acer1 KO mice was compared.The expression levels of intestinal mucosal barriers(ZO-1,Occludin,Claudin,JAMA)were detected by RT-PCR and immunohistochemistry.Systemic immune response levels(IL-1b、IL-6、IL-23、IL-17、IL-10,and TNF-a)were assessed by ELISA and intestinal inflammatory infiltration levels(TNF-a、IL-1b、IL-6、IL-17、IL-21,etc.)were assessed by RT-PCR.Results There was no significant difference between C57 and Acer1 KO mice in free drinking water.In the DSS induced UC model,compared with C57 mice,the survival rate of Acer1 KO mice decreased,the weight decreased significantly,the mechanical barrier and mucus barrier protein expression levels decreased significantly,the intes-tinal epithelial barrier was seriously damaged,the inflammatory response was strong,and the cytokine infiltration was obvious,with statistical differences(P<0.05).Conclusion Acer1 can inhibit inflammatory infiltration by maintaining the integrity of intestinal mucosal barrier,preventing endotoxin,and delaying the progression of UC.

The exploration and pilot studies of applying blockchain to drug supply chain show great potential in promoting information sharing, collaboration competence among the actors, regulatory efficiency, and etc. In the future, with the help of blockchain, the optimization of the entire supply chain for orphan drugs is expected to be realized. However, there is no such exploration in China at present. This paper systematically sorts out the whole process of supply chain for orphan drugs and the existing problems of the chain. The article concludes that at present, blockchain is mainly used in the " circulation" and " use" of the drug supply chain. It helps to improve the traceability of drugs, to cope with the problem of counterfeit drugs, to enable actors of the drug supply chain to form a collaborative network in optimizing resource allocation, and to improve the operation and supervision efficiency of the supply chain. In the future, the application faces challenges such as high costs in system conversion, lack of personnel awareness, and incomplete supporting systems. Based on the three dimensions of technology, practice, and research, this paper also looks into the future and suggests for the future use of blockchain in the supply chain of orphan drugs by constructing a practice model, the so called DI-GIVE (Digital, Intelligence, Government′s supervision, Innovation, Views of variety, Evaluation-based) hoping to innovate the supply chain of orphan drugs and to ensure the drug use for the patients with rare diseases in China.

Objective To study the role and influence of basic Alkaline ceramidase 1 on mucosal barrier and immune regulation in ulcerative colitis(UC).Methods Acer1 knockout mice(Acer1 KO)were constructed,and the UC model was induced by continuous drinking water of sodium dextran sulfate(DSS)for 7 days,and the severity of symptoms of UC disease in C57 and Acer1 KO mice was compared.The expression levels of intestinal mucosal barriers(ZO-1,Occludin,Claudin,JAMA)were detected by RT-PCR and immunohistochemistry.Systemic immune response levels(IL-1b、IL-6、IL-23、IL-17、IL-10,and TNF-a)were assessed by ELISA and intestinal inflammatory infiltration levels(TNF-a、IL-1b、IL-6、IL-17、IL-21,etc.)were assessed by RT-PCR.Results There was no significant difference between C57 and Acer1 KO mice in free drinking water.In the DSS induced UC model,compared with C57 mice,the survival rate of Acer1 KO mice decreased,the weight decreased significantly,the mechanical barrier and mucus barrier protein expression levels decreased significantly,the intes-tinal epithelial barrier was seriously damaged,the inflammatory response was strong,and the cytokine infiltration was obvious,with statistical differences(P<0.05).Conclusion Acer1 can inhibit inflammatory infiltration by maintaining the integrity of intestinal mucosal barrier,preventing endotoxin,and delaying the progression of UC.

Central venous access device-related thrombosis (CRT) refers to the obstructive or non-obstructive clots formed around the central venous access device (CVAD).It may lead to risks such as loss of vascular access, pulmonary embolism, post-thrombotic syndrome.Due to the heterogeneity of underlying diseases and the specific characteristics of CVAD placement in children, there is insufficient evidence for the diagnosis and treatment of CRT in children.This article reviews the diagnosis, treatment and prevention of CRT in children to provide reference for clinical management.